Purpose: To determine whether or not an extended regimen of prophylactic antibiotics following either open or closed reduction of mandibular fractures is beneficial in lowering the rate of infection in post-operative patients.
Patients and Methods: This study is a retrospective chart review of 150 patients treated operatively for both complicated and uncomplicated mandibular fractures at UNM Health Sciences Center in Albuquerque, NM, between January 1st, 2000 and June 12, 2007. Treatment modalities used were closed reduction with maxillomandibular fixation or open reduction and internal fixation with either wire osteosynthesis or rigid internal fixation. Patients fell into one of two groups: the first group received antibiotics peri-operatively, which consisted of no more than 24 hours of antibiotics in the postoperative period and the second group received extended regimen antibiotics, which consisted of anywhere from 24 hours to 10 days of antibiotics in the postoperative period. 75 patients were included in each group. The type of antibiotic prescribed was at the discretion of the operating surgeon. This study was done using an intention-to-treat analysis. Postoperative infection was diagnosed either subjectively or objectively by the clinician evaluating the patient at follow-up appointments.
Results: In the extended antibiotic group, 8 out of 75 subjects (10.67 percent) developed infection. In the peri-operative antibiotic group, 10 out of 75 subjects (13.33 percent) developed infection. Statistical analysis using chi-square distribution showed that this difference in proportions was not significant (Chi-square=0.06, p=0.8).
Conclusions: This study found that the use of post-operative prophylactic antibiotics does not have a statistically significant effect on post-operative infection rates in surgical management of complicated or uncomplicated mandibular fractures.